The impact of medical therapies and factors related to treatment procedures in women with rheumatoid arthritis and inflammatory bowel disease receiving assisted reproduction: a nationwide cohort study

In women with rheumatoid arthritis and/or inflammatory bowel disease, corticosteroid & embryo transfer at the blastocyst stage were associated with successful assisted reproductive technology. Antiinflammatory/immunosuppressive agents & type of hormone protocols did not have significant importance.

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VOLUME 116, ISSUE 6, P1492-1500

Authors:

Bente Mertz Nørgård, Ph.D., D.M.Sc., Mette Wod, Ph.D., Michael Due Larsen, Ph.D., Sonia Friedman, M.D., Line Riis Jølving, Ph.D., Jens Fedder, Ph.D.

Abstract:

Objective

To examine whether medications used to treat rheumatoid arthritis (RA)/chronic inflammatory bowel disease (IBD), or factors related to the assisted reproductive technology (ART) procedures, impact the success of ART. In women with RA/IBD, initial studies have shown a reduced chance of a live-born child after ART.


Design

Cohort study.


Setting

Nationwide Danish health registries.


Patients

All Danish women with a fresh embryo transfer from January 1, 2006, through 2018. The cohorts comprised 1,824 embryo transfers in women with RA/IBD and 97,191 embryo transfers in women without RA/IBD.


Interventions

Observational, noninterventional study.


Main Outcome Measure

Live birth per fresh embryo transfer.


Results

The chance of a live birth in women with RA/IBD receiving ART, compared with other women receiving ART, had an adjusted odds ratio (OR) of 0.79 (95% confidence interval [CI], 0.68–0.91). Prescribed corticosteroids before embryo transfer were positively associated with a live-born child (adjusted OR, 1.21; 95% CI, 1.12–1.31), while the use of antiinflammatory/immunosuppressive agents did not have significant importance. Intracytoplasmic sperm injection was associated with a reduced chance (adjusted OR, 0.94; 95% CI, 0.90–0.97). Type of hormone treatment protocol did not have significant importance, and transfer at the blastocyst stage was positively associated with a live-born child (adjusted OR, 1.54; 95% CI, 1.46–1.62).


Conclusions

In women with RA and/or IBD, prescribed corticosteroid before embryo transfer and embryo transfer at the blastocyst stage were associated with successful ART. Intracytoplasmic sperm injection was associated with a slightly reduced chance. Antiinflammatory/immunosuppressive agents and type of hormone protocols did not have significant importance.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.